静脉淤血皮瓣的微循环研究

Changes of microcirculation in congested flap

目的探讨静脉淤血皮瓣微循环的变化规律。方法选择兔耳建立静脉淤血的皮瓣模型，采用活体微循环动态观察的方法，观察观察静脉淤血组织内部微循环的变化。结果皮瓣静脉淤血后，其原有微血管的数目逐渐减少，微血流的速度逐渐减慢，红细胞聚集和白色微血栓形成的情况逐渐加重，72h皮瓣原有的微循环系统基本衰竭。静脉淤血后36h，可以观察到有新生微血管的出现；48h，可以观察到较清晰的新生微血管。观察到新生微血管的淤血组织最终成活，而未观察到新生微血管的淤血组织最终坏死。结论对于发生静脉淤血的皮瓣，如果不及时解除淤血的原因，其原有的微循环系统呈不可逆的进行性恶化，而微血管的新生对淤血组织的成活起了重要作用。

Objective To explore the change patterns of mierocirculation in congested flap. Methods A congested flap model for long-term microcirculation observation was set up, and the microcirculation of the congested tissues was observed carefully. Results Following congestion, the number of the capillaries in the congested flap were decreasing, the velocity of the bloodstreams were getting slower, and the aggregation of the red blood cells and the formation of the white thrombus were becoming more serious. About 72 hours later, the original microcirculation system of the flap was nearly exhausted. About 36 hours later, the neogenetic capillaries could he observed, with clear neogenetic capillaries observed at 48 hours. The congested tissues with nascent capillaries survived, while the capillaries without nascent formation suffered from necrosis in the end. Conclusions If the cause is not removed, the microcireulation status of the congested flap would get worse irreversibly, and the nascent capillaries would play an important role in the survival of congested tissues.